Promoting bone callus formation by taking advantage of the time-dependent fracture gap strain modulation.

Delayed union and non-union of fractures continue to be a major problem in trauma and orthopedic surgery. These cases are challenging for the surgeon. In addition, these patients suffer from multiple surgeries, pain and disability. Furthermore, these cases are a major burden on healthcare systems. The scientific community widely agrees that the stability of fixation plays a crucial role in determining the outcome of osteosynthesis. The extent of stabilization affects factors like fracture gap strain and fluid flow, which, in turn, influence the regenerative processes positively or negatively. Nonetheless, a growing body of literature suggests that during the fracture healing process, there exists a critical time frame where intervention can stimulate the bone's return to its original form and function. This article provides a summary of existing evidence in the literature regarding the impact of different levels of fixation stability on the strain experienced by newly forming tissues. We will also discuss the timing and nature of this "window of opportunity" and explore how current knowledge is driving the development of new technologies with design enhancements rooted in mechanobiological principles.

Strategies to Improve Bone Healing: Innovative Surgical Implants Meet Nano-/Micro-Topography of Bone Scaffolds.

Successful fracture healing is dependent on an optimal mechanical and biological environment at the fracture site. Disturbances in fracture healing (non-union) or even critical size bone defects, where void volume is larger than the self-healing capacity of bone tissue, are great challenges for orthopedic surgeons. To address these challenges, new surgical implant concepts have been recently developed to optimize mechanical conditions. First, this review article discusses the mechanical environment on bone and fracture healing. In this context, a new implant concept, variable fixation technology, is introduced. This implant has the unique ability to change its mechanical properties from "rigid" to "dynamic" over the time of fracture healing. This leads to increased callus formation, a more homogeneous callus distribution and thus improved fracture healing. Second, recent advances in the nano- and micro-topography of bone scaffolds for guiding osteoinduction will be reviewed, particularly emphasizing the mimicry of natural bone. We summarize that an optimal scaffold should comprise micropores of 50-150 µm diameter allowing vascularization and migration of stem cells as well as nanotopographical osteoinductive cues, preferably pores of 30 nm diameter. Next to osteoinduction, such nano- and micro-topographical cues may also reduce inflammation and possess an antibacterial activity to further promote bone regeneration.

Variable fixation promotes callus formation: an experimental study on transverse tibial osteotomies stabilized with locking plates.

BACKGROUND: A new locking screw technology, named variable fixation, has been developed aiming at promoting bone callus formation providing initial rigid fixation followed by progressive fracture gap dynamisation. In this study, we compared bone callus formation in osteotomies stabilized with standard locking fixation against that of osteotomies stabilized with variable fixation in an established tibia ovine model. METHODS: A 3 mm tibial transverse osteotomy gap was stabilized in three groups of six female sheep each with a locking plate and either 1) standard fixation in both segments (group LS) or 2) variable fixation in the proximal and standard fixation in the distal bone segment (group VFLS3) or 3) variable fixation in both segments (group VFLS6). The implantation site and fracture healing were compared between groups by means of radiologic, micro tomographic, biomechanical, and histological investigations. RESULTS: Compared to LS callus, VFLS3 callus was 40% larger and about 3% denser, while VFLS6 callus was 93% larger and its density about 7.2% lower. VFLS3 showed 65% and VFLS6 163% larger amount of callus at the cis-cortex. There wasn't a significant difference in the amount of callus at the cis and trans-cortex in groups featuring variable fixation only. Investigated biomechanical variables were not significantly different among groups and histology showed comparable good healing in all groups. Tissues adjacent to the implants did not show any alteration of the normal structure in all groups. CONCLUSIONS: Variable fixation promoted the formation of a larger amount of bone callus, equally distributed at the cis and trans cortices. The histological and biomechanical properties of the variable fixation callus were equivalent to those of the standard fixation callus. The magnitude of variable fixation had a biological effect on the formation of bone callus. At the implantation site, the usage of variable fixation did not raise additional concerns with respect to standard fixation. The formation of a larger amount of mature callus suggests that fractures treated with variable fixation might have a higher probability to bridge the fracture gap. The conditions where its usage can be most beneficial for patients needs to be clinically defined.

Mechanical assessment of local bone quality to predict failure of locked plating in a proximal humerus fracture model.

The importance of osteoporosis in proximal humerus fractures is well recognized. However, the local distribution of bone quality in the humeral head may also have a significant effect because it remains unclear in what quality of bone screws of standard implants purchase. The goal of this study was to investigate whether the failure of proximal humerus locked plating can be predicted by the DensiProbe (ARI, Davos, Switzerland). A 2-part fracture with metaphyseal impaction was simulated in 12 fresh-frozen human cadaveric humeri. Using the DensiProbe, local bone quality was determined in the humeral head in the course of 6 proximal screws of a standard locking plate (Philos; Synthes GmbH, Solothurn, Switzerland). Cyclic mechanical testing with increasing axial loading until failure was performed. Bone mineral density (BMD) significantly correlated with cycles until failure. Head migration significantly increased between 1000 and 2000 loading cycles and significantly correlated with BMD after 3000 cycles. DensiProbe peak torque in all screw positions and their respective mean torque correlated significantly with the BMD values. In 3 positions, the peak torque significantly correlated with cycles to failure; here BMD significantly influenced mechanical stability. The validity of the DensiProbe was proven by the correlation between its peak torque measurements and BMD. The correlation between the peak torque and cycles to failure revealed the potential of the DensiProbe to predict the failure of locked plating in vitro. This method provides information about local bone quality, potentially making it suitable for intraoperative use by allowing the surgeon to take measures to improve stability.

In vitro evaluation of the torsional strength reduction of neonate calf metatarsal bones with Bicortical defects resulting from the removal of external fixation implants.

OBJECTIVE: To compare the torsional strength of calf metatarsal bones with defects produced by removal of 2 different implants. STUDY DESIGN: In vitro mechanical comparison of paired bones with bicortical defects resulting from the implantation of 2 different external fixation systems: the transfixation pin (TP) and the pin sleeve system (PS). SAMPLE POPULATION: Neonatal calf metatarsal bones (n = 6 pairs). METHODS: From each pair, 1 bone was surgically instrumented with 2 PS implants and the contralateral bone with 2 TP implants. Implants were removed immediately leaving bicortical defects at identical locations between paired metatarsi. Each bone was tested in torque until failure. The mechanical variables statistically compared were the torsional stiffness, the torque and angle at failure, and work to failure. RESULTS: For TP and PS constructs, respectively, there were no significant differences between construct types for any of the variables tested. Mean ± SD torsional stiffness: 5.50 ± 2.68 and 5.35 ± 1.79 (Nm/°), P = .75; torque: 57.42 ± 14.84 and 53.43 ± 10.16 (Nm); P = .34; angle at failure: 14.76 ± 4.33 and 15.45 ± 4.84 (°), P = .69; and work to failure 7.45 ± 3.19 and 8.89 ± 3.79 (J), P = .17). CONCLUSIONS: Bicortical defects resulting from the removal of PS and TP implants equally affect the investigated mechanical properties of neonate calf metatarsal bones.

Comparative biomechanical evaluation of a pin-sleeve transfixation system in cadaveric calf metacarpal bones.

OBJECTIVE: To compare proximal fragment displacement and the peri-implant strain using a pin-sleeve cast (PSC) system and a transfixation pin cast (TPC) system on a cadaveric calf metacarpal bone fracture model. STUDY DESIGN: Experimental. SAMPLE POPULATION: Cadaveric calf metacarpal bones (n = 6 pairs). METHODS: Paired samples were instrumented with either the TPC or the PSC systems. Strain gauges were applied proximal to the transfixation implants and the bones encased in cast material. The distal part of the construct was removed to mimic an unstable distal comminuted fracture. Constructs were fixed to the material testing machine and initially loaded in axial compression in their elastic range to determine construct stiffness. Constructs were loaded cyclically with a sinusoidal curve that increased until failure. Variables compared statistically between constructs were the initial construct stiffness and, at given load points, the mean metacarpal axial displacement in loading and unloading condition and mean axial strain. RESULTS: Initial construct mean ± SD axial stiffness was not significantly different between constructs (PSC: 689 ± 258; TPC: 879 ± 306 N/mm). There was no significant difference between either investigated displacements of metacarpal bones transfixed with PSC and those transfixed with TPC at all load points. The PSC constructs had a significant decrease in the recorded mean strain (502 ± 340 µstrain) compared to the TPC construct (1738 ± 2218 µstrain). CONCLUSIONS: The PSC significantly reduced peri-implant strain with comparable axial displacement to the TPC in cadaveric calf metacarpal bones.

Biomechanical and computational evaluation of two loading transfer concepts for pancarpal arthrodesis in dogs.

OBJECTIVE: To evaluate 2 plate designs for pancarpal arthrodesis and their effects on load transfer to the respective bones as well as to develop a computational model with directed input from the biomechanical testing of the 2 constructs. SAMPLE: Both forelimbs from the cadaver of an adult castrated male Golden Retriever. PROCEDURES: CT imaging was performed on the forelimb pair. Each forelimb was subsequently instrumented with a hybrid dynamic compression plate or a castless pancarpal arthrodesis plate. Biomechanical testing was performed. The forelimbs were statically loaded in the elastic range and then cyclically loaded to failure. Finite element (FE) modeling was used to compare the 2 plate designs with respect to bone and implant stress distribution and magnitude when loaded. RESULTS: Cyclic loading to failure elicited failure patterns similar to those observed clinically. The mean ± SD error between computational and experimental strain was < 15% ± 13% at the maximum loads applied during static elastic loading. The highest bone stresses were at the distal extent of the metacarpal bones at the level of the screw holes with both plates; however, the compression plate resulted in slightly greater stresses than did the arthrodesis plate. Both models also revealed an increase in bone stress at the proximal screw position in the radius. The highest plate stress was identified at the level of the radiocarpal bone, and an increased screw stress (junction of screw head with shaft) was identified at both the most proximal and distal ends of the plates. CONCLUSIONS AND CLINICAL RELEVANCE: The FE model successfully approximated the biomechanical characteristics of an ex vivo pancarpal plate construct for comparison of the effects of application of different plate designs.

Prediction of bone strength at the distal tibia by HR-pQCT and DXA.

BACKGROUND: Areal bone mineral density (aBMD) at the distal tibia, measured at the epiphysis (T-EPI) and diaphysis (T-DIA), is predictive for fracture risk. Structural bone parameters evaluated at the distal tibia by high resolution peripheral quantitative computed tomography (HR-pQCT) displayed differences between healthy and fracture patients. With its simple geometry, T-DIA may allow investigating the correlation between bone structural parameter and bone strength. METHODS: Anatomical tibiae were examined ex vivo by DXA (aBMD) and HR-pQCT (volumetric BMD (vBMD) and bone microstructural parameters). Cortical thickness (CTh) and polar moment of inertia (pMOI) were derived from DXA measurements. Finally, an index combining material (BMD) and mechanical property (polar moment of inertia, pMOI) was defined and analyzed for correlation with torque at failure and stiffness values obtained by biomechanical testing. RESULTS: Areal BMD predicted the vBMD at T-EPI and T-DIA. A high correlation was found between aBMD and microstructural parameters at T-EPIas well as between aBMD and CTh at T-DIA. Finally, at T-DIA both indexes combining BMD and pMOI were strongly and comparably correlated with torque at failure and bone stiffness. CONCLUSION: Ex vivo, at the distal tibial diaphysis, a novel index combining BMD and pMOI, which can be calculated directly from a single DXA measurement, predicted bone strength and stiffness better than either parameter alone and with an order of magnitude comparable to that of HR-pQCT. Whether this index is suitable for better prediction of fracture risk in vivo deserves further investigation.

Where do locking screws purchase in the humeral head?

INTRODUCTION: One of the limiting factors in finding the best osteosynthesis approach in proximal humerus fractures is the current lack of information on the properties of the cancellous bone regions engaged by the implants fixing the epiphysis. The aim of this study is to assess the densitometric and mechanical characteristics of these regions when using a proximal humerus locking plate (PHLP). MATERIALS AND METHODS: Nineteen PHLPs were mounted on cadaveric humeri using only their three most distal screws. Subsequently, the plates were removed and the bones were scanned using high-resolution peripheral quantitative computed tomography. Bone mineral density (BMD) was determined in the intact proximal epiphysis and in the exact locations where the six proximal screws would have been positioned concluding the instrumentation. Each plate was then repositioned on its bone and a minimally destructive local torque measurement was performed in the same six locations. A statistical analysis was performed to detect significant differences in the investigated parameters between screw positions, and to test the ability of local torque values to discriminate the bone mineral density of the entire humeral head (BMD(TOT)). RESULTS: Novel data about the cancellous bone engaged by the screws of a PHLP are provided. Different epiphyseal locations showed statistically significant different properties. A local torque measurement was a good predictor of the BMD(TOT). CONCLUSION: Position and direction of the epiphyseal screws on a locking implant are determinant to engage bone regions with significantly better bone quality. A breakaway torque measurement in a given screw position can distinguish between humeral heads with different densitometric properties.

Biomechanical evaluation of two-part surgical neck fractures of the humerus fixed by an angular stable locked intramedullary nail.

OBJECTIVE: The aim of the current study was to see how different interlocking mechanisms would affect construct stability and overall failure in the treatment of two-part surgical neck fractures in the proximal humerus in vitro. METHODS: Left and right bones of eight pairs of fresh-frozen human cadaveric humeri were assigned to either a group with conventional or a group with angular stable distal interlocking. The different experimental interlocking mechanisms were used in a surgical neck fracture model of the humerus (Orthopaedic Trauma Association 11- A3) stabilized by a proximal humeral nail. The following variables were evaluated by biomechanical tests: hysteresis width in bending and torsion, stiffness, and fracture gap movement during cyclic axial loading until failure and the overall failure mechanism of the construct. RESULTS: The angular stable group showed significantly less motion in initial bending and torsion and higher bending stiffness throughout the complete deformation cycle compared with the conventional interlocked group. Fracture gap movement was significantly less in the angular stable group. Higher stability was mainly observed in the early phase of the applied loading pattern; however, ultimate failure was not related to distal interlocking but occurred in the proximal fragment in both groups. CONCLUSIONS: An experimental angular stable distal interlocking system of proximal humeral nails shows higher construct stability in the early phase of fracture fixation in vitro. In terms of overall failure, loss of fixation in the proximal fragment was crucial and not different between groups.

Microdamage accumulation changes according to animal mass: an intraspecies investigation.

The fatigue life of a structure is also influenced by its size. Statistically, a bone from a large animal is expected to bear a higher risk of stress fracture if compared to the same bone from a small animal of the same species. This is not documented in the dog, where individuals can have a 40 times difference in body mass. We investigated the effect of body size on cortical bone microdamage accumulation, cortical microstructural organization (porosity, osteon area, and osteocyte lacunar density), and turnover in dogs with a wide body mass range. The aim was to understand and mathematically model how the bone tissue copes with the microdamage accumulation linked to body mass increase. Calcified transverse cortical sections of 18 canine radii of remarkably different size were examined by means of a standard bulk-staining technique and histomorphometric standard algorithms. Relationships between the investigated histomorphometric variables age, sex and mass were analyzed by general linear multivariate models and exponential equations. Type and location of microdamage and bone turnover were not influenced by body mass. Gender did not influence any parameter. Age influenced bone turnover and activation frequency. Microcrack density was influenced by bone mass. Bones had a similar microstructural organization within the same species regardless of the subject's dimension. Microdamage accumulation is inversely related to bone mass, whereas bone turnover is mass-invariant. We theorize a mass-related change in the bone fracture toughness targeted to reach an optimal unique dimensionless curve for fatigue life.

Net change in periosteal strain during stance shift loading after surgery correlates to rapid de novo bone generation in critically sized defects.

In an ovine femur model, proliferative woven bone fills critically sized defects enveloped by periosteum within 2 weeks of treatment with the one-stage bone-transport surgery. We hypothesize that mechanical loading modulates this process. Using high-definition optical strain measurements we determined prevailing periosteal strains for normal and surgically treated ovine femora subjected ex vivo to compressive loads simulating in vivo stance shifting (n = 3 per group, normal vs. treated). We determined spatial distribution of calcein green, a label for bone apposition in first the 2 weeks after surgery, in 15°, 30°, and 45° sectors of histological cross sections through the middle of the defect zone (n = 6 bones, three to four sections per bone). Finally, we correlated early bone formation to either the maximal periosteal strain or the net change in maximal periosteal strain. We found that treatment with the one-stage bone-transport surgery profoundly changes the mechanical environment of cells within the periosteum during stance shift loading. The pattern of early bone formation is repeatable within and between animals and relates significantly to the actual strain magnitude prevailing in the periosteum during stance shift loading. Interestingly, early bone apposition after the surgery correlates well to the maximal net change in strain (above circa 2000-3000 µÎµ, in tension or compression) rather than strain magnitude per se, providing further evidence that changes in cell shape may drive mechanoadaptation by progenitor cells. These important insights regarding mechanobiological factors that enhance rapid bone generation in critically sized defects can be translated to the tissue and organ scale, providing a basis for the development of best practices for clinical implementation and the definition of movement protocols to enhance the regenerative effect.

Finite element analysis of a novel pin-sleeve system for external fixation of distal limb fractures in horses.

The transfixation pin cast (TPC) is an external skeletal fixation technique used to treat horses with distal limb fractures, but its use is often associated with pin-loosening and an increased risk of treatment failure. To address implant loosening, the pin sleeve cast system (PSC) was recently designed and consists of a pin-sleeve unit inserted into the bone. Each pin runs through a sleeve placed in the bone, making contact at two fixed points only within the sleeve. Each pin is attached to a ring embedded in a resin cast. In this report, the mechanical performance of a traditional TPC pin arrangement was compared with that of the PSC using validated finite element models of bone substitutes previously tested in vitro. The PSC resulted in a marked reduction in peak strain magnitude around the pins and a more even distribution of strain across the bone cortex. The two systems resulted in comparable proximal fragment displacement and had a similar stress concentration around bone defects during implant removal. The findings suggest that the PSC load transfer mechanism is effective even in geometrically complex structures like equine bones.

Biomechanical evaluation of a new fixation technique for internal fixation of three-part proximal humerus fractures in a novel cadaveric model.

BACKGROUND: The optimal surgical treatment for displaced proximal humeral fractures is still controversial. A new implant for the treatment of three-part fractures has been recently designed. It supplements the existing Expert Humeral Nail with a locking plate. We developed a novel humeral cadaveric model and the existing implant and the prototype were biomechanically compared to determine their ability in maintaining interfragmentary stability. METHODS: The bone mineral density of eight pairs of cadaveric humeri was assessed and a three-part proximal humeral fracture was simulated with a Greater Tuberosity osteotomy and a surgical neck wedge ostectomy. The specimens were randomly assigned to either treatment. A bone anchor simulated part of a rotator cuff tendon pulling on the Greater Tuberosity. Specimens were initially tested in axial compression and afterward with a compound cyclic load to failure. An optical 3D motion tracking system continuously monitored the relative interfragmentary movements. FINDINGS: The specimen stabilized with the prototype demonstrated higher stiffness (P=0.036) and better interfragmentary stability (P values<0.028) than the contralateral treated with the existing implant. There was no correlation between the bone mineral density and any of the investigated variables. INTERPRETATION: The convenience of this new IM-nail and locking plate assembly must be confirmed in vivo but the current study provides a biomechanical rationale for its use in the treatment of three-part proximal humeral fractures. The improved stability could be advantageous in particular when medial buttress is missing, even in osteoporotic bone.

In vitro mechanical evaluation of a novel pin-sleeve system for external fixation of distal limb fractures in horses: a proof of concept study.

OBJECTIVE: To evaluate the efficacy of a novel pin-sleeve cast (PSC) system for external fixation of distal limb fractures in horses and to compare it with the transfixation pin cast (TPC) system. STUDY DESIGN: Experimental. SAMPLE POPULATION: One bone substitute each was used for the TPC and PSC systems. The PSC was tested in 4 configurations characterized by different pin preloads. METHODS: Specimens were loaded in axial compression in the elastic range. Variables compared statistically were: bone substitute axial displacement and axial strain measured above implants with strain gauges. Pin preload was correlated with the variables investigated. Load to failure and a fatigue tests supplemented the investigation. RESULTS: The PSC configuration with the highest pin preload showed a significantly lower axial displacement compared with the TPC. No significant differences were observed between all other PSC configurations and the TPC. All PSC systems had a significant decrease in recorded strain compared with the TPC system. Pin axial preload inversely correlated with axial displacement but had no effect on axial strain. In the failure test, the PSC encountered plastic deformation earlier than the TPC. In the fatigue test, the PSC ran >200,000 cycles. CONCLUSIONS: Preliminary in vitro tests showed that the PSC system significantly reduced peri-implant strain while concurrently having comparable axial displacement to the TPC system. CLINICAL RELEVANCE: The PSC system has the potential to reduce the risk of pin loosening in horses.

Estrogen deficiency increases osteoclastogenesis up-regulating T cells activity: a key mechanism in osteoporosis.

Compelling evidences suggest that increased production of osteoclastogenic cytokines by activated T cells plays a relevant role in the bone loss induced by estrogen deficiency in the mouse. However, little information is available on the role of T cells in post-menopausal bone loss in humans. To investigate this issue we have assessed the production of cytokines involved in osteoclastogenesis (RANKL, TNFalpha and OPG), in vitro osteoclast (OC) formation in pre and post-menopausal women, the latter with or without osteoporosis. We evaluated also OC precursors in peripheral blood and the ability of peripheral blood mononuclear cells to produce TNFalpha in both basal and stimulated condition by flow cytometry in these subjects. Our data demonstrate that estrogen deficiency enhances the production of the pro-osteoclastogenetic cytokines TNFalpha and RANKL and increases the number of circulating OC precursors. Furthermore, we show that T cells and monocytes from women with osteoporosis exhibit a higher production of TNFalpha than those from the other two groups. Our findings suggest that estrogen deficiency stimulates OC formation both by increasing the production of TNFalpha and RANKL and increasing the number of OC precursors. Women with post-menopausal osteoporosis have a higher T cell activity than healthy post-menopausal subjects; T cells thus contribute to the bone loss induced by estrogen deficiency in humans as they do in the mouse.

Risedronate reduces osteoclast precursors and cytokine production in postmenopausal osteoporotic women.

UNLABELLED: This paper studies the effect of oral risedronate on osteoclast precursors, osteoclast formation, and cytokine production in 25 osteoporotic women. Risedronate is effective in reducing the number of osteoclast precursors, their formation, vitality, and activity and the level of RANKL and TNF-alpha in cultures. INTRODUCTION: Bisphosphonates inhibit bone resorption by acting against osteoclasts. Some in vitro studies suggest that they induce osteoclast apoptosis; others suggest that they exert an effect on the production of pro-osteoclastogenic cytokines. The effect of risedronate on osteoclastogenesis by peripheral blood mononuclear cells (PBMCs) in postmenopausal osteoporosis has not been previously studied. This paper examined the influence of risedronate on the formation of osteoclast precursors and cytokine production within the compass of osteoclastogenesis in osteoporosis. MATERIALS AND METHODS: This study was conducted on 38 osteoporotic women; 25 patients were treated with risedronate 5 mg/d, whereas 13 were treated with calcium 1 g/d and vitamin D 800 UI/d. The following parameters were assessed: changes in bone turnover, circulating osteoclast precursors, formation of osteoclasts in PBMC cultures, their activity and vitality, and variations in the production of pro-osteoclastogenic cytokines before and after therapy. RESULTS: After 3 mo of risedronate, there was a significant reduction in the number and degree of differentiation of osteoclast precursors, osteoclast formation, vitality and activity, and in the level of RANKL and TNF in cultures and of TNF and osteoprotegerin (OPG) in serum, whereas in the group treated with calcium and vitamin D, there were no significant changes. CONCLUSIONS: Our data show that risedronate is effective in lowering the number of circulating osteoclast precursors, their formation, vitality, and activity in cultures, and in reducing the level of pro-osteoclastogenic cytokines in culture supernatants and in serum.

Allometric scaling and biomechanical behavior of the bone tissue: an experimental intraspecific investigation.

INTRODUCTION: Adaptation of bone to different loads has received much attention. This paper examines the consequences of differences in size on bones from the same animal species. METHODS: The study was conducted on 32 canine radii. Their geometry, densitometry and mechanical properties were determined and one-way ANOVA was used to analyze their distribution by sex. Bending failure was observed during the mechanical test. The bones were then likened to thin beams and the mechanical parameters of interest were appraised via beam theory. A multiple linear regression model with stepwise analyses was employed to determine which parameters rule the mechanical characteristics. The relationships between the bone mass and the parameters investigated were analyzed by means of a model II regression in order to state how the scaling of the bone characteristics act on its mechanical behavior. RESULTS: The linear regression model demonstrated that an animal's mass, its sex and the mineral content and the geometrical properties of its bones almost entirely predict their mechanical behavior. A close fit was found between the experimentally determined and the theoretical slopes of the log regressed allometric equations. The work to failure was found to scale almost linearly with the animal and bone mass and the macroscopical bone material properties were found to be mass invariant. The allometric equations showed that as the animal mass increases, employing proportionally the same amount of tissue, bones get proportionally shorter and proportionally distribute their tissue further from the cross-sectional centroid. CONCLUSIONS: Our results suggest that dimensional analysis on the assumption of geometrical self-similarity and mechanical testing according to classic elastic solutions are reasonable in bones tested in accordance to our set up. The bone geometry is the parameter able to curb the energy effects of an animal mass increase. The allometric scaling of the bone length and the cross-sectional layout, without an increase in the amount of material proportionally employed, preserves linear with the animal mass the amount of energy necessary to fracture a bone and restrain the rise of stresses and strains in the cross-section.

Cross-sectional geometrical properties of distal radius and ulna in large, medium and toy breed dogs.

Fractures of the distal radius and the ulna are the third most common fractures in dogs. Toy and miniature breeds have a propensity to develop antebrachial fractures after falling or jumping. Most affect the distal third of both bones involving between 15% and 37% of the radial length. Larger dogs, instead, typically sustain hyperextension injuries to the carpus. The causative mechanisms for this fracture prevalence in toy dogs are unknown. Breed-related changes in bone geometry and/or mineral density have been suggested as possible etiologic factors. In a multifactorial study, the main etiological factors potentially responsible for determining susceptibility to fractures in toy breeds are considered. The aim of this first study is to evaluate the geometric bone features in different dog sizes. The cortical bone cross-sectional properties along the length of the right radius and the ulna of 28 dogs from three different size categories have been quantified by computerized tomographic scanning. Geometrical cross-sectional parameters were measured and normalized to radial length to allow intergroup comparisons. Discriminant analysis was used to classify the observations into different groups. Through statistical analysis of the normalized values, significant differences in cross-sectional properties of different bone sizes were found. The results suggest that, when proportionally loaded, the antibrachii of toy breed dogs are more susceptible to fracture than those of large breed dogs due to morphological differences.